Role of exercise training on autonomic changes and inflammatory profile induced by myocardial infarction.

Bruno Rodrigues,Fernanda M Consolim-Colombo,Maria-Cláudia Irigoyen,Fabio S Lira,Erico C Caperuto,Juraci A Rocha,Kátia De Angelis

doi:10.1155/2014/702473

Abstract

The cardiovascular autonomic imbalance in patients after myocardial infarction (MI) provides a significant increase in mortality rate, and seems to precede metabolic, hormonal, and immunological changes. Moreover, the reduction in the parasympathetic function has been associated with inflammatory response in different pathological conditions. Over the years, most of the studies have indicated the exercise training (ET) as an important nonpharmacological tool in the management of autonomic dysfunction and reduction in inflammatory profile after a myocardial infarction. In this work, we reviewed the effects of ET on autonomic imbalance after MI, and its consequences, particularly, in the post-MI inflammatory profile. Clinical and experimental evidence regarding relationship between alterations in autonomic regulation and local or systemic inflammation response after MI were also discussed.

Highlights

Since the 50s, when cardiovascular diseases (CVDs) exceeded 50% as a cause of mortality worldwide, a detailed search for better understanding of the risk factors was initiated with the Framingham study
The change in cardiovascular reflexes leads to a generalized activation of the sympathetic nervous system after myocardial infarction (MI) in order to change the heart and peripheral hemodynamics. These changes are initially necessary; chronically, they are associated with reduced heart rate variability and increased blood pressure variability, which contributes with target organ damage, heart failure development, risk of arrhythmias, and sudden cardiac death [20]
Blalock [63] has suggested that the immune system linked in such way to the central nervous system works as a “sixth sense,” being able to detect microbial invasion and other inflammatory substances and to retransmit this information to the brain, triggering responses that would interfere in the initial process

Summary

Introduction

Since the 50s, when cardiovascular diseases (CVDs) exceeded 50% as a cause of mortality worldwide, a detailed search for better understanding of the risk factors was initiated with the Framingham study. MI is estimated to occur in the US every 44 seconds and about 49% of CVD deaths in the country are attributed to cardiac ischemic events [2] Both during and after MI, neurohumoral changes occur in order to minimize the consequences of reduced ventricular function, which is caused by the obstruction of blood flow in the left ventricle (LV) of patients who had experienced an ischemic event. The effectiveness of ET as a great tool in the treatment of patients with established CAD (either with or without MI) has been widely reported in the literature [7, 12,13,14,15,16] In this sense, the purpose of this paper was to review the effects of ET on autonomic imbalance and inflammatory profile after MI. Lack of them, regarding relationship between alterations on cardiac autonomic regulation and local or systemic inflammation response after MI will be discussed

Myocardial Infarction and Autonomic Dysfunction

Autonomic Dysfunction and Inflammatory Response

Aerobic Exercise Training as Therapy

Findings

Conclusions